What is the Healthiest Sleep Position?
While 86% of people favor their side, science and our testing data suggest that back sleeping is generally the healthiest option for spinal alignment and skin health.
The Short Answer
Back sleeping is widely considered the healthiest position. It allows your head, neck, and spine to rest in a neutral position, reducing pressure points and preventing aches. However, if you suffer from sleep apnea or severe snoring, back sleeping may worsen these conditions, in which case side sleeping is preferred.
How you sleep determines how you feel the next day. While comfort is subjective, the mechanics of spinal alignment are not. Based on our tests of over 360 mattresses and deep dives into sleep physiology, here is the breakdown of why back sleeping takes the gold medal, and how other positions compare.
| Position | Prevalence | Pros | Cons | Ideal Firmness |
|---|---|---|---|---|
| Back | ~10-15% | Spinal alignment, reduced wrinkles, prevents acid reflux (if elevated) | Snoring, Sleep Apnea risk | Medium-Firm (6-7) |
| Side | ~86% (Most Popular) | Reduces snoring, good for pregnancy, digestion, brain waste clearance | Shoulder/Hip pressure, facial wrinkles | Soft to Medium (4-6) |
| Stomach | ~10% | Reduces snoring | Neck strain, lower back hyperextension, generally not recommended | Firm (7-8) |
1. Back Sleeping: The Gold Standard
Though only about 10-15% of the population sleeps primarily on their back, it offers the most benefits for the average sleeper without respiratory issues.
The Pros
Neutral Spine: Keeps head, neck, and spine aligned.
Skin Health: Face isn't pressed against a pillow, reducing wrinkles and acne.
Reduced Pain: Minimizes pressure points on hips and shoulders.
The Cons
Snoring: Gravity pulls the tongue back, worsening snoring.
Sleep Apnea: Not recommended for obstructive sleep apnea.
Lower Back: Some may need a small pillow under knees to flatten the lumbar curve.
Pro Tip: If you sleep on your back, you generally need a "Medium-Firm" to "Slightly Firm" mattress (6-7 out of 10) to prevent your hips from sinking too deep. (See our firmness guide.)
2. Side Sleeping: The Crowd Favorite
According to our 2025 survey of 70,000 sleepers, 86% of us are side sleepers at least part of the time. While back sleeping is technically "healthiest" for the spine, side sleeping is the best alternative and is actually medically necessary for some.
- Best for Snoring: Keeps airways open.
- Pregnancy: Sleeping on the left side improves circulation to the heart and placenta.
- Gut Health: Can aid digestion and reduce heartburn.
The downside? The "fetal position" can restrict deep breathing if you curl up too tightly, and pressing your face into a pillow nightly contributes to sleep wrinkles. Side sleepers also require a softer mattress (4-6 out of 10) to cushion the shoulders and hips.
3. Stomach Sleeping: Proceed with Caution
Generally, stomach sleeping is considered the "worst" position. It forces your neck to turn at a 90-degree angle, placing significant strain on the cervical spine. It also often causes the lower back to hyperextend (swayback), leading to morning aches.
If you must sleep on your stomach, you need a Firm mattress (7-8/10) to keep your hips elevated and aligned with your shoulders.
Is Your Mattress Causing You Pain?
Often, we sleep in unhealthy positions because our mattress is too old or the wrong firmness. If your mattress is sagging, you might be twisting your body to find support.
Take the Mattress Finder QuizIn This Guide
Top Recommendations
Leesa Sapira Hybrid
Our top pick for back sleepers. Its medium-firm feel and minimal sinkage create perfect spinal alignment.
The WinkBed
The #1 rated mattress for side sleepers. The pillow-top comfort layer provides ample pressure relief.
Helix Dawn
A firm hybrid designed specifically to prevent hip sinkage. Perfect for stomach sleepers.